Correlation of the pathologic morphology on MRI with International Hip Dysplasia Institute classification in developmental dysplasia of the hip / 中国组织工程研究

BACKGROUND: T?nnis classification is commonly used to quantify the severity of developmental dysplasia of the hip (DDH), which relies on the presence of the epiphyseal ossification centre. Thereafter, a new classification system (IHDI method) has been developed by the International Hip Dysplasia Institute (IHDI). However, the pathologic morphology has not been defined based on the IHDI grade.OBJECTIVE: To analyze the correlation of the pathologic changes of the hip on MRI with IHDI classification.METHODS: Image data of 65 infants (89 hips) with DDH were analyzed retrospectively, with an average age of 20.4 months. The radiographic severity was graded by IHDI system, and the correlation between IHDI classification and pathological changes of the hip was analyzed, by observing the morphology and position of the limbus, and the cartilaginous acetabular index.RESULTS AND CONCLUSION: (1) A positive correlation was detected between severity of the IHDI grades and age at reduction (r=0.456, P < 0.001). (2) Unexpectedly, the cartilaginous femoral epiphysis still remained contacting with the acetabulum in a part of type III DDH. The cartilaginous acetabular index was significantly increased with IHDI grade increasing (P=0.028). (3) The limbus was everted in all of the type I hips; however, inverted or mixed shape accounted about 60% in the type II hips, 86% in the type III, and 97% in the type IV, respectively. (4) These results manifest that the DDH was severer, and the limbus trended to be more inverted with the increasing in IHDI grade. Moreover,understanding the correlation of the pathologic morphology with the IHDI classification is of great significance for planning an appropriate treatment scheme for DDH.

An ultrasonic scoring system for assessing the severity of hepatic fibrosis in patients with chronic hepatitis B / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To discuss the diagnostic value of an ultrasonic assessing system for detecting the severity of hepatic fibrosis in patients with chronic hepatitis B (CHB).</p><p><b>METHODS</b>Ultrasonographic variables were analyzed in 110 CHB patients. An ultrasonic semi-quantitative scoring system using seven ultrasonic morphologic parameters, a Fisher discriminating function and three quantitative ultrasonic parameters was developed. The performance of these methods was also studied and compared.</p><p><b>RESULTS</b>The areas under the curve of the scoring system for different liver fibrosis stages were >or= S2: 0.946, >or= S3: 0.914, and S4: 0.915. The total score was well correlated with the histological stage of fibrosis (r=0.824, P < 0.001). There was a significant difference between the stages of fibrosis. The accuracy of the Fisher discriminating function for identifying three study endpoints was 76.5%, 78.2% and 67.3%. Combining the ultrasonic scoring system and the discriminating function, the specificity was 85%-90% and the accuracy was 77%-84%.</p><p><b>CONCLUSION</b>Our ultrasonic semi-quantitative scoring system is a noninvasive method for quantitating liver fibrosis. If it is used together with a discriminating function, the accuracy of diagnosing liver fibrosis can be significantly increased.</p>

A study of the dosage and efficacy of entecavir for treating hepatitis B virus / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To evaluate the antiviral activity and safety of entecavir in patients with chronic HBV infection as a preliminarily step in selecting 0.1 mg or 0.5 mg as a better dosage for a further large scale clinical trial.</p><p><b>METHODS</b>This was a randomized, double-blinded, placebo-controlled and dose-ranging trial of entecavir usage in 212 patients with chronic HBV infection. The patients were randomly assigned to 3 groups: 0.1 mg entecavir (69), 0.5 mg entecavir (72) and, placebo (71) groups and treated for 28 days. The patients were then followed for 56 days without treatment.</p><p><b>RESULTS</b>The proportion of subjects who achieved the primary endpoint at day 28, with their HBV DNA level decreased >2 log or undetectable, was significantly greater in the entecavir 0.1 mg and 0.5 mg dose groups compared with the placebo group (P < 0.01 for both comparisons). The mean change from baseline in HBV DNA levels at day 28 was greater for entecavir 0.1mg and 0.5 mg groups compared with the placebo group (both P < 0.01). The mean change from baseline in HBV DNA levels at day 28 for entecavir 0.5 mg group was greater than that of the entecavir 0.1 mg group (P < 0.01). During the 56-day post-dosing follow-up phase, the entecavir 0.5 mg group was associated with greater and more sustained suppression of viral replication than the entecavir 0.1 mg group (P < 0.01). There were no clinically meaningful differences in the incidence of any adverse events between the entecavir dosing and the placebo groups.</p><p><b>CONCLUSION</b>Entecavir at both 0.1 mg and 0.5 mg doses demonstrated superior antiviral activity compared with a placebo. Since the entecavir 0.5 mg dose appears to have greater antiviral activity than the 0.1 mg dose and with a comparable safety and tolerability profile, the 0.5 mg entecavir dose could be used in further trials.</p>

Dynamic evolution of MMP-13, TIMP-1, type I and III collagen and their interaction in experimental liver fibrosis / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To obtain a detailed pattern of the dynamic evolution and interactions among MMP-13, TIMP-1, type I and III collagen during experimental liver fibrosis.</p><p><b>METHODS</b>Wistar rats were randomly allocated into a normal group, and a model group. To induce liver fibrosis, rats were intraperitoneally injected with dimethylnitrosamine (DMN) three consecutive times in the first week, then two consecutive times per week, totally for 6 weeks. In the normal control group, rats were treated with saline by the same means. Animals were sacrificed 1, 4, 10, 17, 28, 42, 56 days after starting DMN injections. Conventional histological examinations were performed after hematoxylin and eosin, and Masson stain. Fibrosis stages were classified into 0 to 4. Hydroxyproline contents were determined after liver tissues were hydrolyzed in HCl at 160 degrees C for 2 h and then measured with spectrometry at 560 nm wavelength. mRNA levels of MMP-13, TIMP-1, type I and III collagen were determined by semi-quantitive RT-PCR.</p><p><b>RESULTS</b>In the model group, hepatic type I pro-collagen mRNA expression started to increase on the 10th day after DMN administration (t = 2.85, P < 0.05), type III started to increase on the 28th day (t = 4.16, P< 0.01), and TIMP-1 mRNA expression started to increase on the 4th day (t = 2.60, P < 0.05). They all remained much higher than in the normal group throughout the remaining study period. Hepatic MMP-13 mRNA expression started to increase on the 17th day after DMN administration and remained at a higher level than in the normal group until he 28th day (t = 4.08, P < 0.01), then gradually returned to normal level at the end of the study period.</p><p><b>CONCLUSION</b>Although hepatic MMP-13 expression transiently increased during liver fibrosis, enhanced expression of TIMP-1 from the early periods of liver fibrosis inhibited the collagen degrading ability of MMP-13, therefore, over-expressed collagen accumulated in the liver. Thus, it is hypothesized that TIMPs play a pivotal role in liver fibrosis.</p>